The Technoscientific Physician

Recommendation. Engage physicians more fully in biomedical discovery, and reform the biomedical research ecosystem to make that possible: realign funding behind shared missions; promote convergence science; foster cross-sector bridges; build rigor, reproducibility, and trust; back bold people, not legacy institutions per se; and democratize access to frontier tools. Fund a range of creative training pathways, including protected post-residency research years, doctoral work during fellowship, mid-career re-entry, and joint appointments that do not require abandoning practice. Make research culture an explicit object of reform within the medical academy, because the clinician who enters discovery late and works part-time is the first person a poor culture excludes in an RVU-shaped ecosystem. Track three measures the profession does not currently track: whether a clinician with a good question and no infrastructure can get it answered; whether the interval from bedside observation to first experiment has shortened; and whether the people doing this work look different from those who did it a decade ago. Confer authority to physicians to evaluate, validate, and implement new clinical technologies, exercising informed agency over the tools of care rather than being disempowered downstream adopters. Instill curiosity and wonder deliberately and sustain it from medical school onwards, as one effective antidote to physician burnout.